Complication rate low for CRNA lumbar epidural injections

(HealthDay)—Complication rates for fluoroscopic-guided lumbar epidural steroid injections (LESIs) performed by certified registered nurse anesthetists (CRNAs) are similar to physician rates cited in the literature, according to a study published online Jan. 27 in the Journal for Healthcare Quality.

Donald E. Beissel, D.N.P., from Southwest Interventional Pain Specialists in Albuquerque, N.M., conducted a survey of CRNA pain practitioners. He collected data on the number of fluoroscopic-guided LESIs performed and each of 20 complications for a six-month period.

Beissel found that participants practiced in urban (23 percent) and rural (77 percent) settings in office/clinic (31 percent), hospital (62 percent), and mixed (7 percent) practices. CRNAs had both master's (62 percent) and doctoral (38 percent) degrees. Experience in performing fluoroscopic-guided LESIs ranged from one to 17 years and 50 to 12,000 procedures. For each complication, the rate of occurrence was below 1 percent, with the highest rates for bruising and vasovagal reactions. There were no cases of paralysis or death. There was no association between either practice setting or experience level and complication rates.

"CRNAs were able to safely and effectively perform fluoroscopic-guided LESIs with complication rates similar to physician rates cited in the literature," the authors write.

The author has a financial stake in a pain-related services enterprise.

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